Advancing brachytherapy: The GEC-ESTRO strategic vision

Introduction Brachytherapy (BT) is an established and highly effective component of modern radiotherapy, offering a favourable therapeutic ratio for several tumor sites. Despite technological advances and strong clinical evidence, its use has declined in some countries. The GEC-ESTRO Committee of ESTRO therefore initiated a strategic process to promote and strengthen BT within European radiation oncology. Methods The BT Think Tank (B3T), established in September 2024, comprised eight European BT specialists supported by ESTRO staff. Through structured discussions, topic prioritisation and feedback from the GEC-ESTRO Committee, key barriers to the wider implementation and promotion of BT were identified and strategic actions developed. Results Five major areas were identified: communication, scientific research, training, reimbursement and technical development. Communication was ranked as the highest priority. Particular emphasis was placed on improving communication with patients, referring and non-BT specialists, other scientific societies, industry and healthcare stakeholders. To implement this strategy, five communication work packages were established addressing patients, other scientific societies, social media, industry, and healthcare administration/insurance. Specific milestones and activities were defined through 2028. In parallel, ongoing initiatives address clinical research, including prospective trials and real-world evidence, structured training programmes such as the EuroBT Fellowship, reimbursement analyses, and evaluation of technical developments. Conclusion The GEC-ESTRO strategic vision aims to reposition BT as an integral component of personalised, value-based radiotherapy within the overarching strategy of ESTRO. Strengthening communication and interdisciplinary collaboration, alongside continued investment in research, training and advocacy, is essential to ensure that BT is considered as a treatment option for appropriate patients and remains accessible in the future.